Over the years, I’ve taught thousands of IBCLC candidates. I felt sure I’d heard every imaginable question about the IBLCE exam. No, apparently not! While teaching outside of Boston last week, a participant in my review course asked, “What is most important to study for the IBLCE exam?”
The question stopped me dead in my tracks. Yet, because she had flown from Dubai to attend the course, I felt obligated to come up with an answer. Honestly, I suspect she was asking for a topic, but I didn’t address it that way. After a brief pause to consider her questions, here’s what I told the group.
1. Know your terminology.
I’ve harped and harped and harped on how it’s most important to study terminology, but I’ll say it again! Unless you know the meaning of a word, you cannot possibly answer a question about it. Know medical terms, as well as medical prefixes and suffixes.
2. Know critical principles.
We may not always realize it, but many or most of our clinical decisions are based on principles. (Or at least, they should be!) Knowing guiding principles helps with answering questions with qualifiers such as “Which would you do FIRST…” or “Which action is MOST important…” or “The PRIMARY purpose is…” Principles guide our decision-making in general, and especially our priorities for care.
3. Know normal parameters.
In my experience, especially as a clinical instructor, I’ve noticed that students often don’t know what constitutes “normal” or variations of normal. Therefore, they can’t recognize what is outside the realm of normal, i.e., abnormal. Knowing normal parameters is imperative.
4. Know age-appropriate parameters and recommendations.
Similarly, normal parameters vary with age. What’s appropriate for a 4-hour old baby is not necessarily appropriate for a baby who is 4 days, 4 weeks, or 4 months old. This is true about intake, output, and other physiologic data. And, it’s most important to study age-appropriate parameters so that you can give anticipatory guidance. (Weaning is a good example.)
5. Know what factors make the situation different.
We all know situations where some recommendation is effective, and possibly even the standard of care. But we also need to recognize situations where that approach isn’t appropriate. For example, applying ice might indeed reduce venous congestion. But in some cultures, any type of “cold” is forbidden in the early postpartum period.
6. Know your scope of practice.
Knowing your role and responsibilities is crucial. For example, IBCLCs overstep their legal boundaries if they declare that a medication is safe for a mother or baby. The IBLCE exam presumes that IBCLC candidates do not have prescriptive privileges. Therefore they are not qualified to make a medical risk/benefit decision.
7. Know how to carry out common procedures.
Not always, but generally, a procedure is a step-by-step series of actions. It’s most important to study this in the context of using equipment. (Although it certainly could be something else.)
8. Study with a global headset.
Many IBCLC candidates assume that what is done in their hospital or their community is the “right answer.” Not necessarily! The IBLCE exam views counseling and recommendations from a global perspective, and generally considers the World Health Organization as having the last word on breastfeeding management.
9. What is most important to study in terms of topics?
All of the topics listed on the detailed content outline! Take each topic and ask yourself:
- Do I truly understand this term? (Perhaps force yourself to write at least three paragraphs to explain the who-what-where-when-which-why-how of each term.)
- What critical principles govern my counseling or decision-making related to this condition or situation?
- What are the normal parameters related to this condition or situation, and how would you recognize what’s abnormal?
Keep going, using each of the “know this” suggestions I’ve given in this post. And consider my review courses (live or online) if the DIY approach seems a little overwhelming.
I admit, everyone will probably tackle this differently. How would you respond to the question about what’s most important to study for the IBLCE exam?